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, David Lenn, BA SCPO (USN), 2d Marine Raider Battalion, Marine Forces Special Operations Command (MARSOC) , Camp Lejeune, NC 28547, USA Search for other works by this author on: Oxford Academic Daniel T Le, BS ENS (USNR), University of North Carolina School of Medicine, Bondurant Hall, CB #9500 , Chapel Hill, NC 27599, USA Search for other works by this author on: Oxford Academic Christopher J Scheiber, MD Department of Anesthesiology, N2198, CB7010, The University of North Carolina at Chapel Hill, UNC Hospitals , Chapel Hill, NC 27599-7010, USA Search for other works by this author on: Oxford Academic Alan M Smeltz, MD Cardiothoracic Division, Department of Anesthesiology, N2198, CB7010, The University of North Carolina at Chapel Hill, UNC Hospitals , Chapel Hill, NC 27599-7010, USA Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0001-7261-3947 Military Medicine, Volume 189, Issue 9-10, September/October 2024, Pages e2268–e2273, https://doi.org/10.1093/milmed/usad444
Published:
10 November 2023
Article history
Received:
26 June 2023
Revision received:
19 September 2023
Editorial decision:
26 October 2023
Accepted:
01 November 2023
Corrected and typeset:
10 November 2023
Published:
10 November 2023
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David Lenn, Daniel T Le, Christopher J Scheiber, Alan M Smeltz, The Perfect Med Bag is One that Doesn’t Fall Off a Cliff: A Combat Mass Casualty Case, Military Medicine, Volume 189, Issue 9-10, September/October 2024, Pages e2268–e2273, https://doi.org/10.1093/milmed/usad444
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ABSTRACT
Military trauma provides a unique pattern of injuries due to the high velocity, high kinetic energy ammunition utilized, and the high prevalence of blast injury. To further complicate this, military trauma often occurs in austere environments with limited logistical support. Therefore, military medical providers are forced to learn nonstandard techniques and when necessary, practice a level of improvisation not commonly seen in other medical fields. The case presented in this manuscript is a prime example of these challenges. At the onset of fighting both the medic’s rucksack, carrying with it the primary source of medical gear and the precious supply of cold-stored blood products are lost. The scenario was further complicated by rough mountainous terrain and a prolonged evacuation time. The medical provider was forced to utilize nonstandard devices such as an improvised junctional tourniquet which used a rock to focus the devices pressure. They also adapted their basic understanding of surgical procedures to conduct a vascular cutdown procedure for wound exposure and effectively pack an otherwise non-compressible wound to a major artery. Despite a significant loss of equipment, the medic and their team were able to successfully care for a number of patients in this mass casualty scenario.
© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Issue Section:
Case Report
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